Medical suction device

ABSTRACT

A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

This is a continuation of application Ser. No. 12/385,976, filed Apr.24, 2009, (now U.S. Pat. No. 8,100,892), which is a continuation ofapplication Ser. No. 10/287,060, filed Nov. 4, 2002, (now U.S. Pat. No.7,540,868), which is a continuation of application Ser. No. 09/844,490,filed Apr. 27, 2001, (now U.S. Pat. No. 6,517,531), the entirety ofwhich are incorporated herein by reference.

TECHNICAL FIELD

The invention relates generally to medical suction devices and moreparticularly to suction devices that are used together with a mechanismfor destroying or fragmenting objects within the body of a patient.

BACKGROUND INFORMATION

Suction devices can be used in the body to remove objects and fragmentsof objects, such as stones, other calculi, and/or tissue, as well asfragments thereof. A laser fiber can be used to deliver laser energy tosuch objects and/or fragments to fragment the objects and/or fragments.

SUMMARY OF THE INVENTION

The invention relates generally to medical suction devices and moreparticularly to suction devices that are used together withobject-destroying or object-fragmenting mechanisms such as a laserfiber. Such devices and mechanisms typically are introduced into thebody of a patient through a channel of a scope, such as a rigid,semi-rigid, or flexible nephroscope, to fragment and aspirate objectsand fragments of objects, such as kidney stones, other calculi, and/ortissue, as well as fragments thereof.

In one aspect, the invention involves a medical device. The medicaldevice includes a dual-lumen elongated member. The dual-lumen elongatedmember includes a proximal end and a distal end. A first one of thelumens provides a suction passageway and a second one of the lumensreceives a laser fiber which delivers laser energy through the secondlumen and beyond the distal end of the elongated member. The medicaldevice further includes a handle coupled to the proximal end of theelongated member. The handle includes a housing which defines a cavity,a first proximal opening, and a second proximal opening. The firstproximal opening receives the laser fiber and allows the laser fiber topass through the cavity and the second lumen and out of the distal endof the elongated member. The handle further includes a suction tubedisposed within the cavity and in fluid communication with the firstlumen and the second proximal opening. The suction tube is flexible andselectively collapsible to control suction through the first lumen. Thehandle further includes a positioning mechanism. At least a portion ofthe positioning mechanism is disposed within the cavity and anotherportion is external to the housing. The positioning mechanism contactsthe laser fiber and allows the laser fiber to be moved longitudinallywithin the second lumen by manual manipulation of the external portionof the positioning mechanism by an operator of the medical device.

In one embodiment, the handle further includes a suction controlmechanism for controlling a suction path within the suction tube. Thesuction control mechanism crimps the suction tube and seals the suctionpath when the suction control mechanism is in a first position anduncrimps the suction tube and opens the suction path when the suctioncontrol mechanism is in a second position. The suction control mechanismincludes a button or a lever.

In another embodiment, the dual-lumen elongated member includes atransparent material or a translucent material.

In one embodiment, the dual-lumen elongated member includes a rigidmaterial, and in another embodiment, the dual-lumen elongated memberincludes a flexible material.

In some embodiments, the portion of the positioning mechanism externalto the housing includes a thumb wheel, a slide bar, or a plunger.

In another embodiment, the medical device further includes a drainagetube that is external to the housing. The drainage tube includes aproximal end and a distal end. The distal end of the drainage tube is influid communication with the second proximal opening and the proximalend of the drainage tube is in fluid communication with a suction pump.

In still another embodiment, the distal end of the dual-lumen elongatedmember includes a tapered end. An outside diameter the first one of thelumens at the tapered end is smaller than an outside diameter of thefirst one of the lumens at the proximal end.

In yet another embodiment, the handle further includes a fiber clip forholding the laser fiber extending out of the first proximal opening.

In another aspect, the invention involves a medical device. The medicaldevice includes a dual-lumen elongated member. The dual-lumen elongatedmember includes a proximal end and a distal end. A first one of thelumens provides a suction passageway and a second one of the lumensreceives a laser fiber which delivers laser energy through the secondlumen and beyond the distal end of the elongated member. The medicaldevice further includes a handle coupled to the proximal end of theelongated member. The handle includes a housing which defines a cavity,a first proximal opening, and a second proximal opening. The firstproximal opening receives the laser fiber and allows the laser fiber topass through the cavity and the second lumen and out of the distal endof the elongated member. The handle further includes a suction tubedisposed within the cavity and in fluid communication with the firstlumen and the second proximal opening. The suction tube is flexible andselectively collapsible to control suction through the first lumen. Thehandle further includes a positioning mechanism disposed entirely withinthe cavity. The positioning mechanism is in contact with the laser fiberand retains the laser fiber in a position within the second lumen whileallowing the laser fiber to be moved longitudinally within the secondlumen by manual manipulation of a portion of the laser fiber external tothe handle by an operator of the medical device.

In one embodiment, the handle further includes a suction controlmechanism for controlling a suction path within the suction tube. Thesuction control mechanism crimps the suction tube and seals the suctionpath when in a first position and uncrimps the suction tube and opensthe suction path when in a second position. The suction controlmechanism includes a button or a lever.

In some embodiments, the dual-lumen elongated member includes atransparent material or a translucent material. In other embodiments,the dual-lumen elongated member includes a rigid material or a flexiblematerial.

In some embodiments the medical device further includes a drainage tubeexternal to the housing. The drainage tube includes a proximal end and adistal end. The distal end of the drainage tube is in fluidcommunication with the second proximal opening and the proximal end ofthe drainage tube is in fluid communication with a suction pump.

In other embodiments, the distal end of the dual-lumen elongated memberincludes a tapered end. An outside diameter the first one of the lumensat the tapered end is smaller than an outside diameter of the first oneof the lumens at the proximal end.

In still another embodiment, the handle further comprises a fiber clipfor holding the laser fiber extending out of the first proximal opening.

The foregoing and other objects, aspects, features, and advantages ofthe invention will become more apparent from the following descriptionand from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, like reference characters generally refer to the sameparts throughout the different views. Also, the drawings are notnecessarily to scale, emphasis instead generally being placed uponillustrating the principles of the invention.

FIG. 1A is an illustrative side view of a medical suction deviceaccording to one embodiment of the invention.

FIG. 1B is an illustrative perspective view of a distal end of themedical suction device shown in FIG. 1A.

FIG. 1C is an illustrative side view of the distal end of the medicalsuction device shown in FIG. 1A.

FIG. 1D is an illustrative top view of the medical suction device shownin FIG. 1A.

FIG. 2 is an illustrative view of a medical suction device with a distalend disposed in a kidney according to one embodiment of the invention.

FIG. 3A is an illustrative view of inside the housing of a medicalsuction device depicting the suction function deactivated according toone embodiment of the invention.

FIG. 3B is an illustrative view of inside the housing of the medicalsuction device shown in FIG. 3A with the suction function activated.

FIG. 4 is an illustrative cross-sectional side view of a dual-lumenelongated member according to one embodiment of the invention.

FIG. 5 is an illustrative cross-sectional top view of a medical suctiondevice depicting a laser fiber positioning mechanism according to oneembodiment of the invention.

FIG. 6 is an illustrative cross-sectional top view of a medical suctiondevice depicting a laser fiber positioning mechanism according toanother embodiment of the invention.

FIG. 7 is an illustrative cross-sectional top view of a medical suctiondevice depicting a laser fiber positioning mechanism according to stillanother embodiment of the invention.

FIG. 8 is an illustrative cross-sectional top view of a medical suctiondevice depicting a laser fiber positioning mechanism according to yetanother embodiment of the invention.

FIG. 9 is an illustrative diagram of a device used to clean a medicalsuction device according to one embodiment of the invention.

FIG. 10A is an illustrative diagram of a suction device according toanother embodiment of the invention.

FIG. 10B is an illustrative perspective view of a distal end of thesuction device shown in FIG. 10A.

DESCRIPTION

The invention relates generally to medical suction devices and moreparticularly to suction devices that receive and allow the use of anobject-destroying or object-fragmenting device such as a laser fiber.The suction device together with the laser fiber (or otherdestruction/fragmentation mechanism) typically are introduced into thebody of a patient through a channel of a scope, such as a rigid,semi-rigid, or flexible nephroscope, to fragment and aspirate objectsand fragments of objects, such as stones, other calculi, and/or tissue,as well as fragments thereof.

Referring to FIGS. 1A, 1B, and 1C, in one embodiment, the medicalsuction device 100 includes a dual-lumen elongated member 102 and ahandle 126. The dual-lumen elongated member 102 includes a distal end104, a proximal end 106, a first lumen 122, and a second lumen 124. Thedual-lumen elongated member 102 includes on the distal end 104 a taperedtip 134. The tapered tip can 134 include a bright colored marker 132. Inone embodiment, the dual-lumen elongated member 102 is constructed of aclear or translucent material which enables a user to easily identifyany blockage in the first lumen 122. In other embodiments, thedual-lumen elongated member 102 can be constructed of polymeric ormetallic material and can be rigid, semi-rigid, or flexible. Thedual-lumen elongated member 102 is typically produced through anextrusion process.

The handle 126 includes a housing 110, a strain relief 108, a suctionactuation button (“suction button”) 112, a suction port 120, a suctionconnector 130, a laser fiber port 116, a slide bar 114, and a fiber clip138. The housing 110 includes a first housing portion 142 and a secondhousing portion 140. The suction connector 130 is in communication withthe first lumen 122 via a suction tube (discussed in further detailbelow) and extends out of the suction port 120. In some embodiments, thehandle 126 is constructed of a polymeric or metallic material and istypically produced through an injection molding or machining processes.In some embodiment, the housing 110 is constructed of a polymeric,ceramic, or metallic material and is typically produced through astamping, molding, or machining process.

Referring to FIGS. 1A and 2, in one illustrative use, an incision ismade in a patient 202 and a scope, such as nephroscope 218, for example,is inserted into a patient's organ, such as a kidney 204. The distal end144 of a laser fiber 118 is inserted into the laser fiber port 116, fedthrough the housing 110, and into the second lumen 124. The laser fiber118 is advanced through the second lumen 124 until the distal end 144 ofthe laser fiber 118 reaches the end of the second lumen 124. The laserfiber 118 is then secured to a portion of the slide bar 114 that isdisposed in the housing 110 and discussed in further detail below. Theproximal end 146 of the laser fiber 118 is then connected to an energysource, such as a Holmium laser 216, for example. Any excess laser fiber118 extending between the laser fiber port 116 and the laser 216 can becoiled and secured by the fiber clip 138.

The dual-lumen elongated member 102 is inserted into the nephroscope 218through port 220 and advanced through the nephroscope 218 until at leastthe distal end 104 extends out of the nephroscope 218 and into thepatient's kidney 204. An external suction tube 214 is connected to asuction pump 212 and the suction connector 130. Suction through thefirst lumen 122 is controlled by the suction button 112. When thesuction button 112 is in a first (default) position, suction through thefirst lumen 122 is deactivated. When the suction button 112 is pressed,suction through the first lumen 122 is activated.

After a physician, or other medical personnel, inserts the dual-lumenelongated member 102 into the patient's kidney 204 through thenephroscope 218, the physician looks through the nephroscope eyepiece222 to locate an object for removal, such as a kidney stone 206, andmoves the distal end 104 of the dual-lumen elongated member 102 close tothe kidney stone 206. The physician can also manually move the laserfiber 118 longitudinally into or out of the second lumen 124 by movingthe slide-bar 114 longitudinally. Moving the laser fiber 118 in thismanner allows the physician to more accurately position the laser fiber118 near the kidney stone 206.

After the laser fiber 118 is positioned, the laser 216 is activated. Thelaser beam (indicated by arrow 208), which can be either a constant beamor an intermittent pulse, strikes the kidney stone 206 and breaks thekidney stone 206 into smaller debris. As (and/or after) the kidney stone206 breaks up, the physician presses the suction button 112. When thesuction button 112 is pressed, suction is activated in the first lumen122 and the debris in the kidney 204 is aspirated into (as indicated byarrow 210) the first lumen 122. The debris is drawn through the firstlumen 122, through the housing 110, and out of the suction connector130. The debris is further drawn through the external suction tube 214and ultimately discarded. In one embodiment the first lumen 122 canaspirate an object of up to one and a half millimeters in diameter.After the debris in the kidney 206 is completely removed, the suctionbutton 112 is released and suction through the first lumen 122 isdeactivated. This process is repeated until all the kidney stones 206 inthe kidney 204 are removed. Alternatively, suction from the first lumen122 can used to prevent the kidney stone 206 from moving before laserenergy is applied. As the kidney stone 206 is fragmented, the debris isdrawn into the first lumen 122. A benefit of this method is that thekidney stones 206 are removed more easily and quickly.

Referring again to FIG. 1B, in one embodiment, the distal end 104 of thedual-lumen elongated member 102 includes a tapered tip 134. The opening136 of the first lumen 122 at the tapered tip 134 has a smaller diameterthan the diameter of the rest of the first lumen 122. The tapered tip134 minimizes clogging of the first lumen 122 by only allowing in debristhat is smaller than the diameter of the first lumen 122. In oneembodiment, the length of the tapered tip 134 is five millimeters. Inanother embodiment, the tapered tip 134 includes a bright color marker132. The bright color marker 132 allows the physician to easily locatethe distal end 104 of dual-lumen elongated member 102 when the distalend 104 is disposed within a patient and being viewed through anephroscope. Additionally, the bright color marker 132 allows thephysician to be able to distinguish the first (suction) lumen 122 fromthe laser beam emanating from the second lumen 124. The bright colormarker 132 can also be used as an ultrasonic or fluoroscopic marker forlocating the distal end 104 within the patient's body.

In some embodiments, the tapered tip 134 is produced by heat forming orheat bonding polymeric or metallic material to the distal end 104 of thedual-lumen elongated member 102. In other embodiments, the bright colormarker 132 is a molded component coupled to the tapered tip 134. Instill other embodiments, the bright color marker 132 is painted on thetapered tip 134, or produced by a chemical process.

Referring to FIGS. 3A and 3B, in one embodiment, a suction tube 302disposed within the housing 110 connects the dual-lumen elongated member102 to the suction connector 130. The suction connector 130 ispositioned such that the portion of the suction connector 130 thatconnects to the suction tube 302 is disposed within the housing 110 withthe rest of the suction connector 130 extending through the suction port120. When the suction button 112 is not pressed (default position), thesuction button 112 is positioned such that a rigid member 304 pressesagainst the suction tube 302 thereby crimping the suction tube 302 andpreventing suction from the pump 212 (FIG. 2) from extending through thefirst lumen 122. This feature allows the physician to manipulate themedical suction device 100 within the patient's body without removingexcessive amounts of body fluids.

When the suction button 112 is pressed, the suction button 112 ispositioned such that the rigid member 304 no longer presses against thesuction tube 302 resulting in suction extending through the first lumen122. As long as the suction button 112 is pressed, suction through thefirst lumen 122 is active. As soon as the suction button 112 isreleased, suction through the first lumen 122 is deactivated. In anotherembodiment, a lever is used to selectively enable and disable suction inthe same way the suction button 112 is used to selectively enable anddisable suction. In another embodiment, the suction through the firstlumen 122 can be reversed and used for irrigation by connecting thesuction connector 120 to a pump that provides bi-directional flow.

In some embodiments, the suction tube 302 is constructed of anelastomeric material with a memory. In other embodiments, the suctionconnector 120 is constructed of a polymeric material with a smooth boreand is typically produced through an injection molding or machiningprocess.

In another embodiment, before the medical suction device 100 is firstused, a shipping tab (not shown) is first removed from the handle 126.The shipping tab is positioned proximate to the suction button 112 andholds the suction button 112 in the pressed position thereby keeping thesuction tube 302 uncrimped. After the shipping tab is removed, thesuction button 112 functions as previously described.

Referring to FIGS. 3A, 3B, and 4, in one embodiment, an access hole 402is cut into a wall of the dual-lumen elongated member 102 to provide anseparate access point to the second lumen 124. An extension tube 306 isinserted into the access hole 402 and is held in place by glue orfriction. The intersection of the dual-lumen elongated member 102 andthe extension tube 306 is held together and reinforced by strain relief108. The strain relief 108 also prevents the dual-lumen elongated member102 from kinking when inserted into a scope and acts as a plug toprevent body fluids from flowing back through the scope. The extensiontube 306 provides a path for the laser fiber 118 to enter the secondlumen 124 from within the housing 110 because the end of the dual-lumenelongated member 102 is coupled to the suction tube 302. The extensiontube 306 also blocks the suction from the suction tube 302 and providessupport for the laser fiber 118.

In some embodiments, the access hole 402 can be created by a hole punch,a hot stamp, a scalpel, or a drill press. The extension tube 306 isconstructed of polymeric or metallic material and is typically producedthrough an extrusion or dipping process. The strain relief 108 isconstructed of polymeric or metallic material and is typically producedthrough a machining or molding process.

Referring to FIGS. 1A, 1B, 4, and 5, in one embodiment, the distal end144 of the laser fiber 118 is inserted into laser fiber port 116 and fedthrough the housing 110 and into the extension tube 306. The laser fiber118 is then fed through the extension tube 306 and into the second lumen124. The laser fiber 118 is fed through the second lumen 124 until thedistal end of the laser fiber 118 reaches the tapered tip 134. However,prior to entering the extension tube 306, the laser fiber 118 is fedthrough a clamp 504 which is part of a laser fiber positioning system502 that is disposed within the housing 110 and coupled to at least oneslide-bar 114 through an opening 128. As the laser fiber 118 is fedthough the various parts of the medical suction device 100, the clamp504 is held in an unclamped state thereby allowing the laser fiber 118to move through the clamp 504. Once the distal end 144 of the laserfiber 118 reaches the tapered tip 134, the clamp 504 clamps the laserfiber 118. Thereafter, the laser fiber 118 is manually advanced andretracted by longitudinally sliding the slide bar 114 as shown by arrow506.

In some embodiments, the clamp 504 is constructed of a polymeric,ceramic, or metallic material and is typically produced through amolding or machining process. Additionally, the clamp 504 includeselastomeric pads or covers which cushion and prevent damage to the laserfiber 118 when clamped. In other embodiments, the slide bar 114 isconstructed of a polymeric or metallic material and is typicallyproduced through an injection molding or machining process.

Referring to FIG. 6, in another embodiment, the laser fiber 118 ispositioned between two thumbwheels 602 and fed through a grommet 604.The laser fiber 118 is held in position by the grommet 604 throughfriction and can be retracted or advanced along the second lumen 124when the thumbwheels 602 are manually rotated clockwise andcounterclockwise. In another embodiment, the thumbwheels 602 are not inconstant contact with the laser fiber 118. In this embodiment, thethumbwheels 602 must be squeezed or pressed inward toward the housing110 to first make contact with the laser fiber 118 and held in thesqueezed positioned while being rotated in order to advance and retractthe laser fiber 118.

Referring to FIG. 7, in still another embodiment, the laser fiber 118 isfed through and gripped by a plunger 702 that moves in and out of laserfiber port 120. In this embodiment, the laser fiber 118 is selectivelyretracted and advanced by sliding the plunger 702 in and out of thelaser fiber port 120 using a thumb-ring 704. When the plunger 702 is notmanually moved, the plunger 702 held motionless through a frictionconnection with laser fiber port 120.

Referring to FIG. 8, in yet another embodiment, the laser fiber 118 isfed through a grommet 802 and held in position by friction. In thisembodiment, the laser fiber 118 is selectively retracted and advanced bygripping the laser fiber 118 between two fingers at, or near, location802 and pulling the laser fiber 118 out of the housing 110 or pushingthe laser fiber 118 into the housing. The selected position of the laserfiber 118 is maintained by the friction from the grommet 802. In yetanother embodiment, the selected position of the laser fiber 118 ismaintained by the combined friction from the second lumen 124, theextension tube 306, and the laser fiber connector port 116.

Referring to FIG. 9, in some embodiments, a cleaning device 900 isincluded with the dual-lumen access device 100. The cleaning deviceincludes handle 906, shaft 902, and bristles 904. The cleaning device isused to remove debris trapped in the first lumen 122 by inserting thecleaning device 900 into the distal end 104 of the first lumen 122 andmanually moving the cleaning device 900 longitudinally in the firstlumen.

Referring to FIGS. 10A and 10B, in an alternative embodiment, themedical suction device 1000 includes a single-lumen elongated member1002 and a handle 1004. The single-lumen elongated member 1002 includesa distal end 1010, a proximal end 1020, and a lumen 1012. The handle1004 includes a suction actuation button 1006, a suction tube 1008, anda laser fiber port 1018. The single-lumen elongated member 1002 furtherincludes a laser fiber retention clip 1016. The housing 110 includes afirst housing portion 142 and a second housing portion 140. The suctiontube 1008 is in communication with the lumen 1012 through a tube (notshown) disposed in the handle. A laser fiber 1014 is fed through thelaser fiber port 1018, fed through the handle, and through the lumen1012 until the laser fiber 1014 reaches the distal end 1010 of thesingle-lumen elongated member 1002. The laser fiber 1014 is restrainedat the distal end 1010 with the laser fiber retention clip 1016.

Variations, modifications, and other implementations of what isdescribed herein may occur to those of ordinary skill without departingfrom the spirit and scope of the invention. Accordingly, the inventionis not to be limited only by the preceding illustrative description.

What is claimed is:
 1. A medical device, comprising: an elongated memberhaving a proximal end, a distal end, a first lumen extendinglongitudinally through the elongated member, and a second lumen,separate from the first lumen, extending longitudinally through theelongated member, the first lumen for providing suction, the secondlumen for receiving a laser fiber for delivering laser energy beyond thedistal end of the elongated member, the first and second lumensproviding the only lumens through the elongated member; and a handlehaving a first actuation mechanism configured to selectively enablesuction within the first lumen and a second actuation mechanismconfigured to position the laser fiber relative to the distal end of theelongated member, wherein a distal end of the first lumen is taperedwhere the second lumen is untapered.
 2. The medical device of claim 1,further comprising a flexible suction tube within a cavity of thehandle, the flexible suction tube being in communication with the firstlumen.
 3. The medical device of claim 2, wherein the first actuationmechanism is configured to seal a suction path in the suction tube whenin a first position and open the suction path when in a second position.4. The medical device of claim 3, wherein the first actuation mechanismis one of a button or a lever.
 5. The medical device of claim 1, whereinthe second actuation mechanism includes a pair of rotatable thumbwheels,wherein a portion of the thumbwheels is disposed within the handle forcontrolling longitudinal movement of the laser fiber within the secondlumen.
 6. The medical device of claim 1, wherein the second actuationmechanism includes a plunger, wherein a portion of the plunger isdisposed within the handle for controlling longitudinal movement of thelaser fiber within the second lumen.
 7. A medical device, comprising: anelongated member comprising a proximal end and a distal end, theelongated member having a first lumen for providing a suctionpassageway, and a second lumen for receiving a laser fiber fordelivering laser energy beyond the distal end of the elongated member;and a handle having a suction tube in communication with the firstlumen, wherein the handle is configured to provide suction in thesuction tube and in the first lumen; wherein a distal portion of theelongated member is tapered where the second lumen is untapered, andwherein a distal termination of the elongated member has a flat planethat is perpendicular to a longitudinal axis of the elongated member,the distal termination defining a first aperture in communication withthe first lumen for applying suction and a second aperture for receivingthe laser fiber from the second lumen.
 8. The medical device of claim 7,wherein a cross-sectional area of the first lumen along the distalportion of the elongated member is less than that of a remaining portionof the first lumen.
 9. The medical device of claim 8, wherein the firstlumen has a semicircular cross-sectional shape and wherein the secondlumen has a circular cross-sectional shape.
 10. The medical device ofclaim 7, further comprising a laser fiber positioning mechanism havingat least a portion thereof disposed within the handle for controllinglongitudinal movement of the laser fiber within the second lumen. 11.The medical device of claim 7, wherein the distal portion comprises atranslucent material.
 12. The medical device of claim 7, wherein thedistal portion has a color different from that of a remaining portion ofthe elongated member.
 13. A medical device, comprising: an elongatedmember comprising a proximal end and a distal end, the elongated memberhaving a first lumen for providing a suction passageway, a second lumenfor receiving a laser fiber for delivering laser energy through thesecond lumen and beyond the distal end of the elongated member; and asuction tube disposed within a cavity of a handle and in communicationwith the first lumen, the suction tube being configured to selectivelycontrol suction through the first lumen; wherein the first lumen has adiameter along a length of a distal portion of elongate member that isless than a diameter along a length of a remaining portion of the firstlumen, and wherein a distal termination of the elongated member has aflat plane perpendicular to a longitudinal axis of the elongated member,and wherein the second lumen has a constant diameter from the proximalend of the elongate elongated member to the distal end of the elongateelongated member.
 14. The medical device of claim 13, wherein the distalportion is tapered.
 15. The medical device of claim 13, wherein thedistal portion comprises translucent material.
 16. The medical device ofclaim 13, wherein, a portion of the distal end has a color differentfrom that of the remaining portion of the elongated member.
 17. Themedical device of claim 13, wherein the suction tube is flexible and thehandle is configured to crimp the suction tube to control suction.